乌司他丁对腔静脉成形肝移植术肾功能的保护作用  

Protective effect of ulinastatin on renal function in liver transplantation with suprahepatic venacavaplasty

作　　者：周斌[1] 何咸兵[1] 龙云[1] 孙浩[1] 赵建生[1] 

机构地区：[1]解放军第八一医院麻醉科,南京市210002

出　　处：《临床麻醉学杂志》2008年第8期667-669,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察腔静脉成形肝移植术患者肾功能的变化与乌司他丁对肾功能的保护作用。方法71例腔静脉成形肝移植术患者,随机给予乌司他丁30万IU或等量生理盐水,持续静脉输注1h,新肝期再重复一次。根据腔静脉平均阻断时间分成≤62min组,其中用乌司他丁23例(U1组)、生理盐水18例(C1组);>62min组,其中用乌司他丁13例(U2组)、生理盐水17例(C2组)。监测血流动力学、血气、生化指标、肾功能指标、凝血功能、体温、尿量及出血量等。结果下腔静脉阻断(IVC)时间为(62.3±11.2)min。与术前相比,所有患者术后24h血尿素氮(BUN)明显升高(P<0.01),血肌酐(Cr)在新肝期1h、术毕、术后24h均明显升高(P<0.01)。术后24hBUN、CrU1组明显低于C1组(P<0.01),U2组亦明显低于C2组(P<0.01)。而U1与U2组、C1与C2组BUN、Cr差异无统计学意义。结论腔静脉成形术肝移植术对肾功能有明显损伤,术中使用乌司他丁对肾脏有一定程度的保护作用。Objective To evaluate the protective effect of ulinastatin on renal function in the patients undergoing liver transplantation with suprahepadc venacavaplasty. Methods Seventy-one patients undergoing liver transplantation were randomly received either ulinastatin or the same amount of normal saline. The patients in group U received intravenous infusion of ulinastatin 3 × 10^5 IU in 100ml normal saline over 1 h after skin incision, subsequently repeated in the neohepadc phase. The patients in group C were given normal saline instead of ulinastatin. Hemodynamics, blood gas, biochemistry,renal function （BUN and Cr） coagulation function, temperature, urinary output and bleeding output were monitored perioperatively. Results BUN in all patients increased significantly on the first day after liver transplantation compared with that before. Cr in all patients increased significantly from neohepatic phase to the first day after operation （P〈0. 01）. The increase of BUN and Cr in group U was significantly lower than that in group C （P〈0.01）. Conclusion The renal function is significantly injured during liver transplantation with suprahepadc venacavaplasty. Ulinastatin has. a certain protective effect on renal function in the patients undergoing liver transplantation.

关 键 词：肝移植术 乌司他丁 肾功能 

分 类 号：R614[医药卫生—麻醉学]